安氏Ⅱ类错伴颞下颌关节紊乱病患者髁突位置和咬合早接触的临床研究

Clinical study of condylar position and premature contact in Angle Ⅱ malocclusion patients

目的:探讨安氏Ⅱ类错伴颞下颌关节紊乱病(temporomandibular disorders,TMD)患者的髁突位置和CR位咬合早接触位置。方法:收集安氏Ⅱ类错颞下颌关节正常者和TMD患者各23例,拍摄头颅CBCT分析髁突位置;获取并记录患者CR位,在架上检查患者早接触位置。结果:TMD组颞下颌关节前间隙大于正常组,差异有统计学意义(P<0.05)。正常组髁突位于中位占63.1%(29/46);TMD组患者髁突后移位占52.2%(24/46)。TMD组患者CR位牙齿早接触发生部位更偏向牙列远中。结论:安氏Ⅱ类错伴TMD患者髁突多处于后移位,正畸治疗前应先恢复髁突正常位置,再设计矫正方案。

Objective To investigate the condylar position and premature contact of Angle Ⅱ malocclusion patients without and with TMD. Methods 23 patients with Angle Ⅱ malocclusion without TMD and another 23 patients with AngleⅡ malocclusion with TMD were included in the study. CBCT was performed in all patients to scan bilateral temporomandibular joint so as to evaluate the position of the condyle. ThenDelar wax was used to record occlusion of CR and red occluding paper and silver paper were used to inspect premature contact. Results Anterior joint space of TMD group was larger than that of the normal group, with significant （P 〈 0.05）. Centric condylar position in the Angle Ⅱ malocclusion patients were 63.1%, of the condylars in the AngleⅡ malocclusion patients with TMD were 52.2%. Premature contact of Angle Ⅱ malocclusion patients with TMD tended to the more distal direction of denture. Conclusion Posterior condylar position is common in Angle Ⅱ malocclusion patients with TMD, and orthodontists should restore to a normal condylar position before designing treatment plan.